Recurrent Ventricular Tachycardia and Fibrillation Treated with a Combination of Beta-Adrenergic Blockade and Electrical Pacing

Abstract

Recurrent ventricular tachycardia occurs most often in patients with organic heart disease. Less commonly this arrythmia occurs in young individuals without underlying heart disease. Although this arrhythmia is generally considered benign when it occurs in these young patients the episodes of paroxysmal ventricular tachycardia may sometimes lead to syncope and sudden death. Both beta-adren-ergic blocking drugs and electrical pacemakers were used separately in the treatment of paroxysmal ventricular arrhythmias. The present case report describes a 15-yr. -old girl with no evidence of underlying heart disease who had recurrent episodes of ventricular fibrillation. After a combination of procaine amide, atropine and propranolol failed to control these ectopic tachycardias, a radio-frequency pacemaker was inserted. With the combined use of propranolol and electrical stimulation of the left atrium, arrhythmias have not recurred, and this mode of therapy may, therefore, have been life-saving.